Lead Poisoning in Refugee Children

Overview

Most cases of lead poisoning occur in children from low-income regions with poor environmental regulation. Newly arrived refugee children are at elevated risk due to exposure to lead-based paints, contaminated soil or water, and traditional remedies.

Routine Screening

Routine blood lead level screening is NOT recommended in asymptomatic children.

When to Screen

Screen children under 6 years of age who have:

*     Lived in poverty

*     Iron deficiency (iron deficiency increases lead absorption)

Always test refugee children with:

*     Unexplained neurocognitive deficits (developmental delay, low IQ)

*     Unexplained hearing loss

*     Unexplained nephropathy

Clinical Presentation

Lead poisoning can be asymptomatic at low levels. At higher levels:

*     Neurocognitive impairment (most important long-term effect)

*     Developmental delay

*     Behavioural problems

*     Abdominal pain and constipation

*     Anemia

Management

Any detectable blood lead level should be discussed with a Paediatrician and followed up with identification and removal of the exposure source. The Paediatrician will guide further management, including chelation therapy if indicated.